Conditions

HEEL PAIN
There are many causes of heel pain. These include Heel Bone stress fracture, fat pad inflammation and nerve entrapment. However the most common cause of heel pain is Plantar Fasciitis or a “Heel Spur”. This condition is usually characterised by pain to the bottom or inside of the heel, often radiating along the arch of the foot. This pain often occurs first thing in the morning or after any period of sitting and then standing up and usually gets worse as the day progresses. Many people think this pain is due to a heel spur or spike which is often seen on an x-ray of a painful heel. However not all people with Plantar Fasciitis have this spur and many who do have this spur have no problems. What actually causes this condition is the Plantar Fascia, which is a band of flesh like gristle, which extends from the bottom of the heel to the ball of the foot. This band of flesh acts as a truss for the arch of the foot giving it support.

When the foot over-pronates (flattens) the arch of the foot lowers and elongates, stretching the Plantar Fascia. This causes small tears along the length of the Fascia and its pulling away from its connection at the heel bone.

This condition is relatively easy to treat and the sooner treatment is started the quicker healing progresses .A Podiatrist will treat this condition by strapping the foot, giving advice on Footwear and exercises. If the condition is long-standing or severe orthoses(insoles) will be needed to reduce the foot over-pronating. Some therapists will give a Steroid injection into the heel. This is not a great idea as it stops inflammation, which is needed for normal healing. Thus when the steroid wears off after a number of weeks or months the over-pronation has continued to cause damage to the Plantar Fascia even though it is not felt until the steroid has stopped working. This can result in a much worse damaged and painful Plantar Fascia, which will take longer to heal. Steroid therapy can be useful when used in conjunction with orthoses(insoles) This condition can be successfully treated without surgery.